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HYPOOSMOLAR MESODISSOLUTION® AND HYDRO LIPODYSTROPHY « AT LAST, IT WORKS »
Dr Christian Bonnet, Dr Jean-Jacques Perrin, Dr Bernadette Pasquini
As of its birth, Mesotherapy had essentially 2 axes of clinical applications:
- The locomotor apparatus, with lots of works which led to the D.I.U on Pain.
- Aesthetic Medicine, with empirical results, but without significant work supported by visualized para clinical evidence.
Today it is done with a descriptive investigation on hydrolipodystrophies with clinical measures and para clinical measures with echography, about a technique called “hypoosmolar Meso dissolution”.
Indeed, until these last years, we had used the usual pharmacological mixtures suggested by mesotherapists:
- Mésocaïne 1% or Procaïne
- Fonzylane®
- Calcitonine which has advantageously replaced Peridil Héparine and Thiomucase according to Dalloz Bourguignon, with an effect even on the lipolysis.
- For others it’s Dicynone® or DHE for the venous component, or Vit. C, as an anti radicalary.
- For caffeine, we think that it is a matter of dosage and of adequate or inadequate osmolarity of the active principle and that is why its action is well tolerated (hypoosmolar caffeine) or badly tolerated (hyperosmolar caffeine).
We will not communicate about products without French AMM of the AFSSAPS because we do not use them.
Up to now, results in Mesotherapy for the cellulite were problematic and changeable because we do not have reliable measuring devices for the hydrolipodystrophy. Furthermore, mixtures and techniques have not been the subject of any consensual protocol which one could have controled.
Also, it is at the moment when we were interested in the American works on the treatment of the cellulite by hypoosmolar solutes, that we tried to couple this process to Mesotherapy by adapting techniques and mixtures, in order to obtain the best synergy possible.
The most interesting American works are those of Pr. Stevin, M. Hoeffin, Head of the plastic surgery Department of The Medicine School of Los Angeles (UCLA), called “Hypotonic pharmacological lipodissolution” already published in 1997.
The basic principle is simple and attractive: by injecting a hypoosmolar solute in the subcutaneous greasy tissue, one destroys it by distension and bursting of the adipocytes, under the effect of the differential of the physiological osmolarity (about 300 mOsm/l) and of the prepared hypoosmolar solute (from 100 to 120 mOsml/l) injected in subcutaneous regarding the cellulitic zone.
The author claimed significant results by number since 1997, as far as efficacy and, local and general tolerance are concerned.
We inspired ourselves with the process by adapting it to Mesotherapy, as well in the depth and in the number of injections as in the type of the injected mixtures, in order to have the best results possible.
In fact, we had immediately noticed that the principle of injections of hypoosmolar solutes was painful and brutal in its first technique (particularly the very deep multi injections with I.M. needles injected in S.C.). Moreover we had noticed that this process did not act on the circulatory and anti-oedematous component of the hydrolipodystrophy.
On the other hand we had then observed that the lipolytic action of Mesotherapy on the cellulite was clearly improved by this process. This double action was confirmed by echographic exams.
On this level of the clinical observations, we wanted to draw significant deductions to evaluate the role of the classical Mesotherapy and the role of the hypoosmolar solute, through a descriptive epidemiological investigation.
For this we had prepared judicious hypoosmolar mixtures from physiological serum (NaCl at 9%), water for injectable preparation, mesocaïne 1%, salmon calcitonine 100UI, thiocolchicoside and Vitamin C in order to obtain a total osmolarity of the mixture of 100 mOsm/l. In this way the differential of osmolarity was becoming significant in relation to the osmolarity of the greasy tissues and of the blood plasma (300 mOsm/l). This choice was also motivated by the necessity to obtain a slow and progressive effect to respect the notion of “prolonged release” in Mesotherapy.
The choice and the detailed dosage of the different parts of the mixture can not be taught “by correspondence courses”: in fact the learning of the process and of the preparation of the mixtures can only be done in Specialized Workshops, and by competent lecturer practicioners.
To our classical clinical measuring (size of waist, of thigh, thickness of cutaneous line, etc…), we added echographic exams to visualize the action of this therapeutical process on the circulatory component (oedematous) and the greasy component (adipocytary) of the hydrolipodystrophy.
We noted on the clinical and paraclinic level (echography) a significant correlation of the action of the hypoosmolar Mesodissolution on the “disinfiltrating” effect (anti-oedematous) and on the “slimming” effect (lipolysis of the greasy heaps).
The first observations of the experimental portion indicated to us (around 20 observations) that the most encouraging clinical results set themselves at the level :
- of the hip (EIAS): 3.4 inches (size of waist)
- of the thigh: 1.3 inch
- of the actual cutaneous line: 0.5 inch
The results of echography are also significant, but of lesser importance; in fact the classical echography only shows the lipolytic effect (slimming/greasy) in the hypoderm, whereas the high frequencies echography (dermascan) estimates the derm density from which we can deduce the more or less “disinfiltrating” effect of an anti-cellulite treatment.
The former clinical studies were made on a second portion of 113 observations and, except for 15 little significant cases (loss < 1 cm), and the results were a loss:
- of 0.7 to 4 inches on the TV (average 2.4 inches)
- of 1.2 to 2 inches on TC (average 1.6 inch)
- of 0.4 to1.2 inch on PC (average 0.8 inch)
The clinical measures add up the two actions thus: anti-oedematous (disinfiltrating) of the derm and lipolytic (greasy disintegration) of the hypoderm.
This is the reason why we used the mixed technique:
- D.H.D. (0.4 inch deep)
- And I.E.D or I.D.S (0.04 to 0.08 inch deep) in coating.
Thus, in order to act on the two component of the derm (anti-oedematous aspect) and of the hypoderm (lipolytic aspect), from now on we use the association of the mesotherapy products in a hypotonic solute on the one hand, and the co-technique on the other hand.
The complementary factors which increase the disinfltrating and lipolytic effects of the hypoosmolar mesodissolution, are essentially the “palpate and roll” massages with a caffeinated (5%) slimness cream.
After a year and a half distance, we were able to notice the persistence and even an increase of the long term effects. It seems that a maintenance session every 1 to 2 months brings the best results.
This new technique allows us to increase considerably our efficacy on the assuming of the cellulite and can complete surgical techniques, in post liposuction for example.
ICONOGRAPHY
ABSTRACT
Mesodissolution is a new mesotherapic treatment for the cellulite which comes in order to extend the indications. It is the source of clinical, biological and scan works completed since more than 3 years and more than 3000 patients.
We can finally treat the fibrous cellulites by the lipolytic action of this new technique.
The principle consists of localised hypodermic injections of a hypoosmolarand circulatory mixture. We thus obtain the combination of 2 essential actions, anti oedematous circulatory (mesodraine) and lipolysis (mesodissolution).
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